HomeMy WebLinkAbout0104768-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 572 GRAND ST
Contractor JEFF'S WATER REPAIR
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner DEBORAKSCHNEIDER
Category 411 - Residential-Water Heaters
No 104768
Create Date 10/14/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature
of Work
Replacing the existing water heater with a power vent water heater. Outlet is existing.
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Valuation $700.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided
Issued By
Date
10/14/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address N2586 HWY76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
i£¥ou want this processed through pour account [~
Owner
'~i~gle Family ~]Dnplex [~]Multi-Family ~Rental [--]Commercial
Date
[--lIndustrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well FlrAVst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet Sump Pump Wait. St. Wash Fm
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sofmer Exam Sink Gar Drain
Water Heater ~ Local Waste Sculry Sink Soda Disp
0 Gas [2 Elect'~pwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower
Bidet F Prep Sink Ice Maker
Floor Drain
Beer Tap Serv Sink Site Drain
Lnd~ Tray Classrm Sink lnt Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink
Breakrm Sink R.P.Z. Valve Eye Wash Sm
Sterilizer
Electric Contractor
Use / Nature of Work
OR
~]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
# Conn. Type
7/03